MEDICARE: FRANCISCO JAVIER MARTINEZ PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	PT17853	CA
2	2251E1200X	Ergonomics Physical Therapist	PT17853	CA
3	225100000X	Physical Therapist	PT17853	CA
4	2251N0400X	Neurology Physical Therapist	PT17853	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT17853	OTHER	CA	PT LICENSE
2	0PT178530	OTHER	CA	BLUE SHIELD PIN

General Provider Information

NPI Number	:	1619317658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCISCO JAVIER MARTINEZ PT

Provider Business Mailing Address
First Line	:	2010 W AVENUE K # 686
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93536-5229
Country	:	US
Telephone Number	:	661-948-1999
Fax Number	:	661-948-6699

Provider Business Practice Location Address
First Line	:	2010 W AVENUE K # 686
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93536-5229
Country	:	US
Telephone Number	:	661-948-1999
Fax Number	:	661-948-6699

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2013
Last Update Date	:	07/29/2015

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